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Non-Alcoholic Fatty Liver Disease (NAFLD)

What is non alcoholic fatty liver disease (NAFLD)?

Non alcoholic fatty liver disease (NAFLD) refers to a wide spectrum of liver diseases ranging from the most common, fatty liver (accumulation of fat in the liver, also known as steatosis), to non alcoholic steatohepatitis (NASH, fat in the liver causing liver inflammation), to cirrhosis (irreversible, advanced scarring of the liver as a result of chronic inflammation of the liver). All of the stages of non alcoholic fatty liver disease are now believed to be due to insulin resistance, a condition closely associated with obesity. In fact, the BMI correlates with the degree of liver damage, that is, the greater the BMI the greater the liver damage. The term non alcoholic is used because liver disease due to alcohol can show the same spectrum of liver disease NAFLD.

“The NAFLD is the single most common liver abnormality in the United States. It is linked to the growing epidemic of obesity in adults as well as in children. NAFLD is a self-inflicted liver disease, much like alcoholic liver disease”

Incidence & Information Sources for NAFLD

NAFLD affects an estimated 10-24% of the world’s population.

In the US, the CDC reports that about one half of the U.S. adult population is overweight (BMI>25) and one quarter is obese (BMI>30). Upwards of 29 million Americans have non alcoholic fatty liver disease, while 6.4 million of these persons have non alcoholic steatohepatitis (NASH). Even more alarming than these statistics, non alcoholic fatty liver disease is occurring among children in the US.

Complications

The main complication of liver disease of nonalcoholic fatty liver and non-alcoholic fatty liver disease (NAFLD) is cirrhosis, which is the end-stage scarring (fibrosis) of the liver.

Cirrhosis occurs in response to liver damage, such as inflammation in nonalcoholic hepatic steatosis. While the liver tries to stop the inflammation, it produces areas of scarring (fibrosis). With a continuous inflammation, the fibrosis expands to appropriate more and more liver tissue.

If the process does not stop, cirrhosis can produce:

Accumulation of fluid in the abdomen (ascites)

Swelling of the veins in the esophagus (esophageal varices) that can break and bleed

Disorientation, drowsiness and stammering (hepatic encephalopathy)

Liver cancer

End-stage liver failure which means that the liver has stopped working

About 20 percent of people with nonalcoholic fatty liver disease develop cirrhosis.

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